One day at a time, but not forever!!!

If you’ve ever gone to a 12-step meeting, you’ve heard the phrase “one day at a time,” so often as to make it a mantra. Personally, it always left me wanting more.

Is “one day at a time” enough?!

I think the notion is a correct one… when it comes to early recovery. However, once the initial excitement of staying sober has worn off and life without the crutch of drugs, alcohol, or any other addiction, begins, I believe that there is great value in planning.

Thinking ahead is exactly the sort of thing that addicts don’t do well. As far as I know, there’s only one way to improve a lacking skill – practice.

If a recovering addict truly takes things “one day at a time,” never making plans that take the not-so-near-future into account, where does that leave him except for being sober for one more day? As far as I’m concerned, that’s simply not enough.

I had a lot of learning to do when it came to living a normal life after I cleaned up. I barely knew how to function in the simplest ways without the crutch I’d become so comfortable with. I’ll never forget the single sentence lesson my dad gave me over the phone regarding handling my mail.

“Most people pick up their mail, open it up on the spot, throw away what they don’t need, and handle the rest immediately” he told me.

To me, that was more than a foreign concept; it just sounded strange. You see, I would let mail pile up for weeks, eventually throwing it away when it simply seemed overwhelming. The notion of taking care of my mail, or anything else for that matter, on the spot, sounded so simple as to be impossible. But guess what – it works!!!

Fortunately for me, by the time my dad had shared those pearls of wisdom, I’d been clean for six months and ready to put the lesson into action.

Making plans the right way

Recently, my fiance introduced me to an exercise that requires you to write down your plans for next week, next month, next year, and five years from now. I liked it because it made me think concretely about where it is I’m going in life both in the very short, and relatively long, future. By writing down how I saw different aspects of my life play out in the next five years, I got to think about them more directly than I ever had before.

I’ve adapted the exercise for addicts in recovery. I think that you should try it as early as you feel comfortable with it. The trick early on is to just complete it. Once the first draft is finished, you should go back and change it every once in a while.

Given how quickly things change in early recovery, the second draft should be completed after a week. Since you’ll be getting better, and more realistic, every time, the third draft should probably be done about a month later. From that point on, further edits can be done whenever life calls for it.

I think you’ll find that simply going through the exercise will tell you a lot about where you are in your recovery.

The exercise itself

The first thing you’ll need is a piece of paper. Divide the paper (you can use one side or both depending on how much you like to write) into five sections and title them as follows: “Tomorrow”, “Next week”, “Next month”, “Next year”, and “Five years from now.”

Under each one of the headings, answer the following questions for each of the time periods. Be as specific as possible. Feel free to add, or replace, any of these questions with ones you see as more relevant to your life.

  1. Where will you be living?
  2. What will your job be?
  3. Will you be in a relationship? If so, with who?
  4. How much money will you be making?
  5. What car (or other mode of transportation) will you have?
  6. List your five most important relationships – Describe the quality of each.
  7. What special trips, events, or occasions, will you be taking part in or planning?

That’s it. You’re done. Take a deep breath and read over the list.

Though it seems simple enough, you’ll see that answering these questions can be quite difficult at first. This is especially true the more specific you try to be (answers like “I’ll be living in a 3 bedroom house in Mar Vista with hardwood floors and a home office that faces east” might take some time for some of you).

Again, the point is simply to complete the exercise that first time. I promise you that it gets easier with time. Since you’ll be repeating it relatively often initially, you’ll be able to adjust your plans according to the changing circumstances of your life. Feel free to go back and redo the list any time.

Having goals, both short and long term ones, will help focus your mind. It will also plant the seed of the direction in which you want to take your life. Without this direction, things can seem chaotic, especially when one has recently given up their best friend (cocaine, marijuana, porn, and chocolate fudge ice-cream can easily be thought of as best friends when one is in the throws of addiction or recently out of it).

One day at a time is great, but when you want more out of life, planning is the only way to go.

About Addiction: Drug use, Addiction Recovery, and smoking

We’re back with our weekly post about addiction news and research. We’ve got harm reduction in Australia, heroin ads that don’t work, the impact of drug abuse on children, and more. Get your 30 seconds of education for the day.

Using Drugs – Heroin, HIV, the law, and recovery

The Australian– There is a state approved heroin injecting room in Australia. The center opened to create a safer place for drug users to shoot heroin. 3500 individuals have overdosed on the premises without a single fatality, making for a very interesting way of combating drug addiction that would definitely fall under that harm-reduction model American hate so much!

Star Advertiser– When it comes to scaring individuals into not using drugs, specifically heroin, fear appeals do not seem to work in preventing future drug users. Fear appeals ads show drug users as violent, and often have missing teeth or skin problems. Apparently, audiences are smart enough to see these as not really representative of heroin users in general and they’re not buying it, making the ads useless in combating drug addiction.

Global Development– Eastern Europe and Central Asia have the fastest growth rate of HIV infection in the world (Russia accounts for between 60% and 70% of the epidemic). This may be due to sharing dirty needles when using drugs and the biggest problem is likely lack of prevention efforts for high risk groups.

Guardian– A senior police officer from Britain thinks that individuals should not be criminally prosecuted for possessing marijuana. By focusing less on drugs found among youth the police can focus on things they see as more important like hard core criminals. I’m sure our legalization friends will love this, although again, this isn’t legalization but decriminalization and parents will hate it.

Addiction Inbox– Meditation and exercise play a role in drug addiction recovery. Both methods apparently help to eliminate the panic and anxiety that plays a role in detoxification. Although it may not be the most popular method of recovery, we at A3 have already written about this and think you should give it a try!

Breaking the cycles–  A program called Partnership for a Drug Free America has five new drug programs in order to eliminate drug use among teens. These programs educate teens as well as their parents with a variety to drug information.

Smoking, pregnancy, and attitude

Science Daily- Women who smoke during pregnancy can hinder their children’s coordination and physical control (likely affecting boys more). Smoking during pregnancy can damage development in the fetal stage, so if you are expecting try not to light up (as our other post on pregnancy and smoking recommends).

Decoder– You are in for a good read on the changing attitudes of smoking. This blog gives an inside perspective on smoking and how it has evolved from the time it was considered “cool”.

Addiction’s impact on others

Philly Daily News- Addiction impacts not only the drug addict but their children as well. 15% of all children live in a household with an alcoholic and one in four children is exposed to a family member’s alcohol abuse or dependence. These children are often neglected when their parents are under the influence and that neglect can lead to some pretty terrible outcomes for the children themselves down the line.

Addiction Recovery– This is an excellent read on the importance of patience when it comes to addiction recovery. Rome wasn’t built in a day and neither will a drug addict’s wonderful new life. Recovery takes time so take a deep  breath and enjoy!

Addiction help, exercise, and recovery – Running to stay clean

As we mentioned in recent posts, giving up addictive behaviors can be difficult.

Research on interventions has long shown that it’s a lot easier to reshape existing behaviors than it is to stop them. Therefore, refocusing, or rechanneling, your energy into something that will improve, not devastate your life should prove easier than simply stopping addictive behavior. Addiction recovery help is often centered on stopping the usage of drugs when instead, they should focus on replacing the use with something else.

Addiction help by active replacement

Exercise has been shown to improve mood, especially in the short term (1,2) and can therefore provide the extra emotional boost many addicts need when they first stop using. An article in the Journal of Sport Psychology reveals that running can create a sense of achievement, fulfill intrinsic and extrinsic needs, and provide a natural high (3).

An activity like running can provide a respite from daily life. It can also offer a means to re-direct most addicts’ need for something to obsess about.

Taking on a long-term running goal and getting involved in some training with appropriate short-term achievement markers can help people in recovery feel as if they’re regaining some measure of control over their seemingly chaotic life. Seeing yourself able to run longer distances, faster times, and feeling the health benefits can be very rewarding.

An inspiring story in Runner’s World magazine tells the story of a father and son who did just this, conquering their drug addiction by taking on the challenge of completing a marathon.

Addiction help, not a new disaster

Importantly, a study has found that animals that are prone to drug addiction are also more likely to develop obsessive running patterns (4). This suggests that a link between these behaviors does indeed exist and underscores the importance of being mindful even when performing these more benign activities; the goal is staying healthy after all.

Keeping this in mind, there are a few simple things that will help reduce the chances of injury as you start running:

Stretching is important for injury prevention. Activities such as yoga are beneficial for runners and can stretch out sore muscles, prevent your next injury, and relieve stress. (Runners World)

Make sure to set realistic running goals and not push yourself too far. Taking on too much too early will only lead to injury and burnout and hurt, not help your enjoyment of running.
So instead of just trying to quit, try changing behaviors that you commonly engage in into ones that are more productive.

Question of the day:

Have you found that running, or a similar form of exercise helped you kick bad habits?
If so, would you mind sharing your story?

contributing author: Katie McGrath

Citations:

1. Plante and Rodin. (1990). Physical fitness and enhanced psychological health. Current Psychology: Research & Reviews, Vol 9, Spr 1990, pp. 3-24.

2. W. De Coverley Veale (1987) Physiological and Psychological Effects of Short-term Exercise Addiction on Habitual Runners, Exercise Dependence Addiction 82 (7) , 735–740.

3. Mark H. Anshel (2005). Applied Exercise Psychology: A Practitioner’s Guide to Improving Client Health and Fitness, Springer Publishing.

4. Werme, M., Thoren, P., Olson, L., Brene, S. (1999). Addiction-Prone Lewis But Not Fischer Rats Develop Compulsive Running that Coincides with Downregulation of Nerve Growth Factor Inducible-B and Neuron-Derived Orphan Receptor 1. The Journal of neuroscience, 19, pp. 6169-6174.

contributing author: Katie McGrath

Crystal meth withdrawal – It’s not like heroin, but don’t expect it to be easy

Heroin, or opiate, withdrawal symptoms is the gold standard of addiction withdrawal. Imagine the worst flu of your life, multiply it by 1000, and then imagine knowing that taking a hit of this stuff will make it all better. Think sweats, fever, shaking, diarrhea, and vomiting. Think excruciating pain throughout as your pain sensors get turned back on after being blocked for way too long. Now you have an abstract idea of the hell and it’s no wonder why heroin withdrawal has become the one every other withdrawal is judged against.

Crystal meth withdrawal

Withdrawing from crystal meth use is nothing like opiate withdrawal and there’s no reason that the withdrawal symptoms should be. Opiates play a significant role in pain modulation and opioid receptors are present in peripheral systems in the body, which is the reason for the stomach aches, nausea, and diarrhea. Dopamine receptors just don’t play those roles in the body and brain, so withdrawal shouldn’t be expected to have the same effect.

But dopamine is still a very important neurotransmitter and quitting a drug  that has driven up dopamine release for a long time should be expected to leave behind some pain, and it does.

One of the important functions of dopamine is in signaling reward activity. When a dopamine spike happens in a specific area of the brain (called the NAc), it signifies that whatever is happening at that moment is “surprisingly” good. The parentheses are there to remind you that the brain doesn’t really get surprised, but the dopamine spike is like a reward signal detector, when it goes up, good things are happening.

Well guess what? During crystal meth withdrawal, when a crystal-meth user stops using meth, the levels of dopamine in the brain go down. To make matters worse, the long-term meth use has caused a decrease in the number of dopamine receptors available which means there’s not only less dopamine, but fewer receptors to activate. It’s not a surprise than that people who quit meth find themselves in a state of anhedonia, or an inability to feel pleasure. Once again, unlike the heroin withdrawal symptoms, anhedonia doesn’t make you throw up and sweat, but it’s a pretty horrible state to be in. Things that bring a smile to a normal person’s face just don’t work on most crystal-meth addicts who are new to recovery. As if that wasn’t bad enough, it can take as long as two years of staying clean for the dopamine function of an ex meth-addict to look anything like a normal person’s.

This anhedonia state can often lead to relapse in newly recovered addicts who are simply too depressed to go on living without a drug that they know can bring back a sense of normalcy to their life. The use of crystal-meth causes the sought-after spike in dopamine levels that helps relieve that anhedonic state.

When it comes to more physiological sort of withdrawal symptoms, the meth addict doesn’t have it that bad, I guess. After an extended period of sleep deprivation and appetite suppression that are some of the most predictable effect of meth, the average addict will do little more than sleep and eat for the first week, or even two, after quitting the drug. Many addicts experience substantial weight gain during this period as their metabolism slows and their caloric intake increases greatly. Like everything else, this too shall pass. With time, most addicts’ metabolism return to pre-use levels and their appetite catches up and returns to normal as well. Still, there’s no doubt that a little exercise can help many addicts in early recovery steer their bodies back on track.

There’s some research being talked about around the UCLA circles to see if detoxification from meth may help people do better in treatment for meth addiction by reducing the impact of their withdrawal. Detox before addiction treatment is an accepted fact in opiate and benzodiazepine addiction, but because of the supposedly “light” nature of crystal meth withdrawal, it’s been ignored. Hopefully by now, you realize that was a mistake.

How I cleaned up my act and dealt with my crystal meth addiction

I keep referring to the fact that I don’t believe in quick fixes for addiction.

My crystal meth addiction

Partially, this is due to research I’ve been exposed to that shows changes in the brain that are very long lasting. As I’d mentioned in an earlier post about crystal meth use, it can take as long as 2 years of staying clean for dopamine function in the brain to return to anything near normal levels, and though we don’t have any clear answers on this yet, the function that does return is most likely not the same as that which was lost.

But it’s also due to my own experience. I used a lot of meth for more than 4 years. It started out with $40 bags (a quarter gram) and eventually grew to almost daily 8-ball use (3.5 grams,), which I could only afford because I was selling pounds of the stuff. I’m sometimes surprised that my brain still functions at all, let alone at the levels it needs to for the things i’m doing now. Still, my memory has suffered and the jury on whether my ADD had worsened due to it or not is still out.

When I got clean, it took me more than 2 years of no substance use whatsoever to get to the point where I felt I was “back to normal.” There were certainly stages of improvement along the way, but I literally had to learn how to live without drugs. It wasn’t easy.

Filling up the necessary recovery time

As you’ll find out continuously throught this blog, my road wasn’t without it’s share of bumps either. I got kicked out of my first rehab for using after about 3 months of staying clean and though my second try was successful, it was far from easy and the struggles taught me a lot about myself and what I am capable of.

I’ve included, and will keep writing, a series of posts about rechanneling addictive personality tendencies into more constructive activities that can help in getting through the tough periods of readjustment. I can say that for me, it was this rechanneling that made it possible to get through my days.

Be it my schooling, working out, or my newfound passion for gardening (on my tiny patio), finding new ways to occupy my restless mind have proven indispenseble for my new, improved life. While I might not have been preparing for it, there’s been a quiet in my mind I didn’t even know before…

Read the upcoming posts for ideas on what you can do to rechannel your energy into things that will improve, not destroy, your life…

Addiction, exercise, recovery: A little less sweating, just as much addiction help!

contributing author: Katie McGrath

We’ve talked quite a bit about the benefits of active habits, especially early in recovery when addicts are looking for things to do instead of drugs and alcohol. If you want to look at another blogger who supports the idea that replacing addictive habits is essential to recovery, you should check out Spiritual River, written by Patrick Meninga. He has numerous blogs the specifically talk about what he calls the “creative theory of addiction.”

As we continue exploring what I call “positive addictions“, the important point to remember is to start small and to find things you enjoy doing. Any hobby that gives you enjoyment and that can take up a certain amount of time each day can serve as a “positive addiction”. In addition to the helpful exercise-recovery activities that we described in our earlier posts (like yoga and running), there are a number of less physically demanding ones that can be at least as helpful.

Other addiction help options!

Research has shown that activities like gardening, painting, listening and playing music, and writing (journaling, poetry writing, literary writing) have all served as positive addictions. We’ll look at each one of these briefly:

– Gardening can increase self esteem by enabling you to care and nurture for a living thing. It can reinforce and evoke positive emotions through growing, harvesting, and experiencing the growth of plants (1). Gardening can allow for an escape into an activity that promotes life while combining creativity and hard work (if you think gardening is easy, you’ve obviously never tried it!).

– Music therapy has also been shown to have a number of positive effects on drug users. We’ve all felt the power of music we love, whether sober, or under the influence. Analyzing lyrics and sharing songs enables people to express their feelings and thoughts in a positive way. In one particular study, relaxing music shortened the time it took subjects to fall asleep and improved mood on the following day (2).

Photgraphy

– Similarly, poetry and writing are pathways to feelings. Poetry therapy enables people to overcome obstacles and painful memories by writing and using words to express their feelings (3). The benefits of putting one’s thoughts on paper (by journaling for example) are also great because they allow one to reflect on internal processes that may be very important but just outside of one’s awareness.

– Lastly, painting is another leisurely activity that has been shown to improve depression and anxiety by inspiring creativity and individuality (4). People can clear an open space in their mind by focusing on their art. While few of us will ever reach the levels of artistic geniuses like Picasso, Van Gough, and Rodin, the physical and emotional benefits of creating the art itself are worth at least as much as the critical acclaim.

Obviously, there are a number of ways to fill the void left by drugs when trying to quit. Addiction help doesn’t come only in the form of exercise. The important thing is to find something that gives you pleasure, takes your focus away from the worries of early recovery, and perhaps, that you can get involved in along with other people to allow for the formation of new, drug-free, relationships.

Best of luck!

Citations:

(1) Kavanagh, Hean. (1998). Outdoor space and adaptive gardening: Design, techniques, and tools. Food Products Press: Binghamton, NY.

(2) Abdollahnejad, Mohammad Reza. (2006). Music Therapy in the Tehran Therapeutic Community. Therapeutic Communities, Vol 27(1), pp. 147-158.

(3) Keith Van Vilet. (1977). Creativity and Self Image: An Odyssey in Poetry and Photography. Psychotherapy. Vol. 4 pp. 9-93.

(4) Gil Bar-Sela , Lily Atid, Sara Danos, Naomi Gabay, Ron Epelbaum. (2007) Art therapy improved depression and influenced fatigue levels in cancer patients on chemotherapy. Division of Oncology, Rambam-Health Care Campus, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

Surfing and exercise in crystal meth addiction recovery

Hey everyone, I’ve already talked about the endless ways in which exercise can help addicts, especially in early recovery, fill the void left by their drug use (see here for some articles).

This NY Times article follows Darryl Virostko, a world class surfer, as he attempts to incorporate surfing and surfing lessons into the rehabilitation efforts of Southern California addicts.

Darryl was himself addicted to crystal meth. Another proof that recovery is possible through many different routes.